Ngozi Ejedimu, a lawyer-turned-entrepreneur, had returned home from an outing one evening in October 2016 when her hand strayed towards her right breast.
The mother of three had settled into her living room to watch one of her favourite TV shows when she felt a hard and immovable lump in her breast. Knowing the lump wasn’t normal, she booked an appointment with her doctor, and her fears were confirmed.
Ejedimu was diagnosed with stage 3 triple-negative breast cancer.
According to WebMD, triple-negative breast cancer is more aggressive than other forms of cancer as it is more likely to have spread beyond the breast at the time it is found.
By the time Ejedimu was diagnosed, the disease had spread to her lymph nodes, making it necessary to remove the affected breast.
“I had my right breast removed through mastectomy before chemotherapy started. I am completely flat on my right side,” she told this reporter while recounting her experiences.
Going through mastectomy was a painful decision to make but Ejedimu didn’t hesitate to go through the process for fear of death.
“I actually tried herbs initially to avoid the mastectomy but God sent sensible people my way to reset my brain in the right direction,” she noted.
Shortly after mastectomy, she started chemotherapy.
“When I started to research on chemo, a lot of things I read just looked scary, so at some point, I just stopped and started praying and handed everything to God,” she said.
Delay in treatment poses a danger
According to the National Institute of Cancer, chemotherapy is a type of cancer treatment that uses drug to treat cancer cells, and it works by stopping or slowing the growth of cancer cells, which grow and divide quickly.
While many Nigerian women correctly associate chemotherapy with cancer, the notion that it leads to death has led some into seeking herbal or spiritual treatment.
Although they later resorted to medical treatment but oftentimes, it was too late for them as the invasive disease had eaten deep into their systems.
For Edna John, another breast cancer survivor, it took three years of pain, bleeding, and discomfort for her to finally agree to a proper treatment at the hospital.
When 25-year-old John was diagnosed with stage 3 triple-negative breast cancer in 2015, she was advised to try alternative means of treatment instead of undergoing surgery and chemotherapy.
“People told me that if I did chemo, I would die. I was scared, so I tried different churches and herbal homes, where I was told that my condition was a spiritual problem,” she said.
By the time she agreed to chemotherapy, the affected breast had got so bad that it had to be removed. According to her, she had nine shots of chemotherapy in April 2019.
With the benefit of hindsight, John said she wished she had submitted herself to chemotherapy earlier.
“I wouldn’t have passed through everything I went through. I detected it very early and when they started telling me it was spiritual, I believed them because there was no cancer history in my family and I was still very young,” she said.
She said she would advise any breast cancer patient to go for chemotherapy so as to avoid the kind of ordeal she faced.
100,000 cases of breast cancer yearly
Nigeria records 100,000 new cases of breast cancer every year, with a high case fatality ratio, according to ResearchGate.
In 2018, the World Health Organisation reported that four per cent of deaths in Nigeria were caused by cancer.
There are many non-governmental organisations championing the fight against cancer in Nigeria but a large number of women still have poor knowledge and wrong beliefs about the disease and its treatment.
Despite reports of improved awareness of breast cancer, the National Center for Biotechnology Information states that patients continue to present late when treatment is least rewarding.
According to the NCBI, the poor knowledge and wrong beliefs among Nigerian women are responsible for a negative perception of the curability of cancer detected early and of the effectiveness of the screening tests.
Unlike John, when Happiness Wokoma was diagnosed with stage 2 breast cancer, she had no hesitation about the form of treatment to undergo. She made up her mind to go through surgery and chemotherapy.
“I never subscribed to alternative medicines, and won’t advise anyone to do so. Until proven effective with at least a 70 per cent success rate, then one could consider it. For now, it is chemotherapy, and nothing else,” she said.
Although the side effects of chemotherapy can be unpleasant, the effectiveness of the treatment far outweighs the pains it causes.
Describing chemotherapy as crazy, Wokoma explained that she lost her hair, became very dark from her crown to her nails, and battled low blood level, low immune system, appetite loss, stooling, constipation, weakness, and restlessness.
She, however, started to recover one month after the cancer treatment ended.
For Ejedimu, chemotherapy was very difficult and she almost gave up on it.
“I had 16 rounds of aggressive chemotherapy. There was no alternative and cancer had spread to the lymph nodes. I lost my hair, my nails turned black, and so many other side effects, with the worse being that there were times I felt like dying. I almost wanted to stop at some point but I didn’t.
“People will always say that they have heard that chemotherapy kills; please always find out the circumstances surrounding the person’s death,” she said.
Coping with fear of recurrence
A family medicine practitioner, Dr Sylvia Kama-Kieghe, said the treatment of breast cancer would depend on the type, stage, and grade of the disease.
According to her, other types of breast cancer treatment apart from chemotherapy include radiotherapy, hormone therapy, and surgery.
“Chemotherapy is generally used as an adjuvant after surgery or radiotherapy to reduce the chance of cancer coming back,” she said.
For many breast cancer survivors, it is difficult to do away with the fear of recurrence.
John is ready to remove her second breast whenever she is able to raise money for it.
“I’m thinking of removing the second one to be on the safer side because sometimes, it comes back to the other breast. The doctors said I should always check the second breast; so, I’m thinking of removing both to take away the risk of cancerous lumps,” she said.
Wokoma said she was also scared of recurrence, and often dashed to the clinic whenever she noticed any change in her body.
But the medical practitioner explained that recurrence of breast cancer is dependent on the type, stage and grade of cancer when detected, the treatment options used and the patient’s state of health and previous medical problems.
Kama-Kieghe stressed the need for early detection and treatment in reducing the risk of recurrence but also explained that a survivor’s family history might also contribute to the risk.
“This is why we advocate regular and constant monitoring with scans for early detection so that treatment can be resumed, targeting any new cells. Treatment for breast cancer will be successful for most people who are treated early, and the risk of recurrence gets less as time goes on,” she said.
Although the number of breast cancer patients who died during chemotherapy is unknown, Kama-Kieghe said that death during chemotherapy should not be a common event.
She said tests and checkups must be carried out because of the aggressiveness of the treatment.
Ejedimu, who is of the view that breast cancer treatment is not cheap at any stage, advised women to be proactive about their health.
This story was first published on Woman.NG and the research was made possible with support from Code for Africa via the WanaData programme.